caa a22 4500 475802209 CHVBK 20180406123740.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1007/s002680010278 doi (NATIONALLICENCE)springer-10.1007/s002680010278 Additional Hepatocellular Carcinomas Undetectable before Surgery [Elektronische Daten] [Taichi Shuto, Kazuhiro Hirohashi, Takashi Ikebe, Shinichi Mikami, Takatsugu Yamamoto, Shoji Kubo, Kenichi Wakasa, Hiroaki Kinoshita] The presence of small additional hepatocellular carcinomas (HCCs) undetectable before hepatic resection is a crucial topic for hepatic surgeons. We assessed the incidence of pathologically diagnosed multiple HCCs in 267 patients who underwent hepatic resection for HCC. Ninety-five additional HCC nodules were detected in 72 of the patients (27%). The survival rate of these 72 patients was significant worse than for the 195 with single nodular HCC (p= 0.0013). Twenty-one (22%) were detected before surgery, 29 (31%) during surgery, and 45 (47%) on pathologic examination after surgery. The mean nodule diameters for each group were 2.1, 1.0, and 0.9 cm, respectively (p < 0.0001). None of the 21 nodules detected before surgery was well differentiated, whereas 30 of the 74 nodules in the other two groups were well-differentiated. Although the mean nodule diameter of the well-differentiated HCC group was the smallest, there was no significant difference among the three groups assigned according to tumor differentiation (p= 0.2355). Altogether, 9 of 16 patients with additional nodules detected before surgery (56%) and 49 of 59 with additional nodules detected during or after surgery (88%) had cirrhosis of the liver. The odds ratio for detecting a new HCC nodule during or after surgery in the presence of cirrhosis was 5.444 (p= 0.0087). Improvement in the detection of small additional HCC nodules before and during surgery and meticulous follow-up after surgery are necessary for patients with cirrhosis. For patients without cirrhosis, surgical treatment may be performed according to the results of preoperative imaging studies. Société Internationale de Chirurgie, 2000 Shuto Taichi Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut Hirohashi Kazuhiro Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut Ikebe Takashi Second Department of Pathology, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut Mikami Shinichi Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut Yamamoto Takatsugu Second Department of Pathology, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut Kubo Shoji Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut Wakasa Kenichi Department of Pathology, Osaka City University Hospital, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut Kinoshita Hiroaki Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut World Journal of Surgery Springer-Verlag 24/12(2000-12-01), 1566-1569 0364-2313 24:12<1566 2000 24 268 https://doi.org/10.1007/s002680010278 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010278 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shuto Taichi Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut NATIONALLICENCE 700 1- Hirohashi Kazuhiro Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut NATIONALLICENCE 700 1- Ikebe Takashi Second Department of Pathology, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut NATIONALLICENCE 700 1- Mikami Shinichi Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut NATIONALLICENCE 700 1- Yamamoto Takatsugu Second Department of Pathology, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut NATIONALLICENCE 700 1- Kubo Shoji Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut NATIONALLICENCE 700 1- Wakasa Kenichi Department of Pathology, Osaka City University Hospital, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut NATIONALLICENCE 700 1- Kinoshita Hiroaki Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan, JP aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/12(2000-12-01), 1566-1569 0364-2313 24:12<1566 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer